Tolbutamide hemolytic anemia with

The most dangerous adverse reaction of sulfonylureas is agranulocytosis. Aplastic anemia (79), red cell aplasia (80), pure white cell aplasia (81), bone marrow aplasia, and hemolytic anemia have been described during treatment with chlorpropamide (82), glibenclamide (83), or tolbutamide (84). 

Blood dyscrasias, mostly dose independent, are among the most important allergic-type adverse reactions to drugs. Aplastic anemia is a serious but rare (presumably) idiosyncratic reaction. It has been reported in association with chloramphenicol, quinacrine, phenylbutazone, mephenytoin, gold compounds, and potassium chlorate. Hemolytic anemia, thrombocytopenia, and agranulocytosis may result from an unusual, acquired sensitivity to a variety of widely used drugs including aminopyrine, phenylbutazone, phenothiazines, propylthiouracil, diphenylhydantoin, penicillins, chloramphenicol, sulfisoxazole, and tolbutamide. 

Drug-dependent antibodies causing IMHA have been found in AIDS patients (Gonzalez et al, 2003). Other cases of IMHA after the administration of tei-coplanin, a glycopeptide antibiotic (Coluccio et al., 2004) and by a metabolite of etodolac, a nonsteroidal anti-inflammatory drug (Cunha et al., 2000), have also been reported. Hemolytic anemia associated with antibodies to older drugs like tolbutamide and phenacetin have been known for decades (Bird et al.,1972). 

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